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Summary: Background: Physical abuse can lead to severe health consequences that extend beyond immediate harm. We explored the associations of physical abuse experienced during childhood and adulthood with a wide range of adult health conditions requiring hospital treatment. Methods: We utilised data from a sub-cohort of 157,366 UK Biobank participants (46.4% of the baseline population; age range 45–81; 89,101 women) and repeated analyses in an independent population of 85,929 adults from the Finnish Public Sector (FPS) study (age range 17–78; 68,544 women). Participants in both cohorts reported instances of physical and sexual abuse at study baseline. Follow-up included 77 common health conditions ascertained from linkage data to national hospital and mortality registries. Findings: Mean follow-up duration was 4.6 years (SD 0.14) in UK Biobank and 10.6 years (4.3) in FPS. Physical and sexual abuse was associated with 22 mental and physical health conditions. After multivariable adjustments, participants who experienced abuse during both early and later stages of life had a 2.12- (95% confidence interval 1.39–3.23) to 3.37-fold (1.52–7.45) increased risk of mental and behavioural disorders, a 1.46 (1.20–1.79) to 1.83 (1.05–3.20) times increased risk of metabolic, haematologic, and respiratory diseases, and a 1.24 (1.07–1.45) times higher risk of inflammatory diseases compared with non-exposed participants. The absolute risk difference between these groups was greatest for metabolic and haematologic conditions (rate 381 and risk difference 160 per 100,000 person-years). Frailty, comorbidities, and competing risk of death did not modify these associations, but the possibility of bias or residual confounding cannot be excluded. Interpretation: Repeated exposure to physical and sexual abuse amplifies the risk of hospitalisations from mental disorders and physical diseases spanning diverse organ systems. Addressing this issue may necessitate multifaceted strategies, including shifts in societal norms, legal measures, and increased healthcare provision for affected individuals and their families. Funding: Wellcome Trust, UK Medical Research Council, U.S. National Institute on Aging, Academy of Finland.

Previous research on adolescent peer networks has mainly focused on friendship networks and their association with violence, but very limited research is available on peer rejection networks. This lack of knowledge hinders the effectiveness of preventing peer rejection and its negative effects. Based on the theory of the cycle of violence, the present study examines the extent to which parental physical abuse experiences, aggressive behavior toward peers and acceptance of violence are related to peer rejection networks at school. Social network analysis with a stochastic actor-oriented model of longitudinal data collected from high school students (Wave 1, n = 620; Wave 2, n = 590) confirms that adolescents who frequently use aggression toward their peers are more likely to be rejected, especially if those adolescents have experienced abuse. Similarly, peers are more likely to reject adolescents with high levels of accepting violence. The results also show that aggression toward peers generally tends to decrease over time but not for adolescents who reject a larger number of students. For students who reject many peers, aggression frequency increases. From the perspective of resilience theory, peer rejection, when combined with aggression toward peers and acceptance of violence, particularly in female adolescents, creates a significant risk factor for socio-emotional development. Therefore, tackling violence attitudes, experiences and behavior in the school environment and at home is crucial in overcoming the cycle of violence.

IntroductionTo understand the family’s role in adolescents’ mental health development and the connection to neurodevelopmental disorders related to experienced parental physical abuse, we first explored resilience pathways longitudinally and secondly, connected the identified patterns to adolescents’ hair cortisol levels that are rooted in the hypothalamic–pituitary–adrenal axis as the main stress response system and connected brain structure alterations.MethodsWe analyzed longitudinal online questionnaire data for three consecutive high school years (from seventh to ninth grade) and four survey waves from a representative sample of n = 1609 high school students in Switzerland on violence–resilience pathways. Furthermore, we collected students’ hair samples from a subsample of n = 229 at survey wave 4. About 30% of the participating adolescents had been physically abused by their parents. Out of the overall sample, we drew a subsample of adolescents with parental abuse experiences (survey wave 1 n = 509; survey wave 2 n = 506; survey wave 3 n = 561; survey wave 4 n = 560).ResultsDespite the odds, about 20–30% of adolescents who have experienced parental physical abuse escaped the family violence cycle and can be called resilient. By applying a person-oriented analytical approach via latent class and transition analysis, we longitudinally identified and compared four distinct violence–resilience patterns. We identified violence resilience as a multidimensional latent construct, which includes hedonic and eudaimonic protective and risk indicators. Because resilience should not solely be operationalized based on the lack of psychopathology, our latent construct included both feeling good (hedonic indicators such as high levels of self-esteem and low levels of depression/anxiety and dissociation) and doing well (eudaimonic indicators such as high levels of self-determination and self-efficacy as well as low levels of aggression toward peers).DiscussionThe present study confirmed that higher cortisol levels significantly relate to the comorbid pattern (internalizing and externalizing symptoms), and further confirmed the presence of lasting alterations in brain structures. In this way, we corroborated the insight that when studying the resilience pathways and trajectories of abused adolescents, biological markers such as hair cortisol significantly enhance and deepen the understanding of the longitudinal mechanisms of psychological markers (e.g., self-determination, self-esteem, self-efficacy) that are commonly applied in questionnaires.

Childhood trauma such as abuse and neglect is serious risk factors that lead to psychological problems in adulthood. We decided to use network analysis to identify childhood trauma and psychological symptoms. 184 non-psychotic patients (Mean Age = 27.80, SD = 10.50, female 79% and male 21%) attending to psychiatric treatment agreed to fulfil a Childhood Trauma Questionnaire including five trauma types (physical abuse, emotional abuse, sexual abuse, physical neglect and emotional neglect) and a Symptom Check List of 10 psychological symptoms (anxiety, depression, phobia, paranoid ideation, psychoticism, anger-hostility, interpersonal sensitivity, somatization, obsessive-compulsive symptoms, eating-sleeping problems). Network analysis revealed that among trauma types emotional and sexual abuse were directly linked with symptoms. Depression and anxiety were identified as the most central symptoms. Despite somatization was found in periphery, it was found an important bridge symptom that enable transition from childhood trauma to adulthood psychopathology. Consistent with previous studies, these results suggest that interaction between trauma types and psychological symptoms in adulthood followed multiple pathways. Future studies should also focus on influences of childhood trauma in later life. [ABSTRACT FROM AUTHOR]

Background: A substantial number of women who subsequently become pregnant and give birth have a history of physical, sexual, and/or child abuse. This study investigated the associations of these types of traumas and their cumulative effect with childbirth experiences, namely, mode of birth, maternal and child complications during pregnancy/childbirth, preterm birth, medical procedures, and obstetric violence during labour. Methods: A group of Russian women (n = 2,575) who gave birth within the previous 12 months, completed a web-based survey, where they provided demographic information, details about their childbirth experiences, and a history of trauma. Results: Women with any type of past abuse were at higher risk for maternal complications during pregnancy/childbirth (exp(β) < 0.73, p < 0.010 for all). More specific to the type of trauma were associations of physical abuse with caesarean birth, child abuse with complications during pregnancy/childbirth for the baby, and physical and child abuse with obstetric violence (exp(β) < 0.54, p < 0.022 for all). There was a cumulative effect of trauma for all the outcomes except for medical procedures during childbirth and preterm birth. Conclusion: This study provides insights into potential different individual effects of physical, sexual, and/or child abuse as well as their cumulative impact on the childbirth experiences. The robust findings about maternal complications during pregnancy/childbirth and obstetric violence highlight the importance of trauma-informed care, supportive policies, and interventions to create safe and empowering birthing environments that prioritise patient autonomy, dignity, and respectful communication. [ABSTRACT FROM AUTHOR]

Background: Child abuse is one of the major health and social problems in the world and has severe short-term and long-term consequences on children's psychological, social and physical functioning. One of the effective strategies to control and prevent child abuse is training parent through web-based applications. The aim of this study is to design and evaluation of child abuse web-based application for parent education and strengthen. Methods: This study is an applied-developmental study that performed in Razi Educational and Therapeutic Center in Tabriz. The study consisted of three main phases. The requirements assessment and design phases were completed between November 2022 and February 2023. The research community was parents referring to Razi Center and convenience sampling was used to select the samples. In firststage, a questionnaire was designed by searching in library sources and consulting with specialists for needs assessment and application design. The questionnaire was completed by psychiatric specialists, health information management and health information technology.Finally, the usability of designed application was evaluated with the participation of 30 parents and specialists. Results: Based on the identified information elements and capabilities, a child abuse web-based application was designed. Application capabilities were such as concepts of child abuse, prevention and treatment strategies, parenting skills, childrens behavioral disorders, child abuse laws and interaction with clinical specialists. Finally, the result of the web-based application usability evaluation was evaluated at a good level equal to an average of 7.6 out of a total of 9 points. Conclusions: The possibility of expressing experiences, exchanging message, attractiveness, ease of use, and accessibility of parents, they were designed as application features. The usability of the web-based application was satisfactory to users in various of overall functionality, display, terminology, learning ability and overall application capability. [ABSTRACT FROM AUTHOR]

Physical violence and social conflict have been widely studied in the ancient societies of the Andes. However, studies about violence are scarce for the Formative period of northern Chile (1000 BC–AD 900). Evidence from these investigations is generally interpreted as interpersonal violence, whose protagonists are mostly men. Here, we present the case of an adult female recovered from the Tarapacá 40 cemetery (Tarapacá region, Chile) displaying lesions suggestive of trauma. We reconstruct her life and death in the context of this era's social and political conditions. Results of our bioanthropological characterization, cranial trauma analysis, carbon and nitrogen isotope analysis, and recording of the funerary offerings suggest she was a local member of the Formative community buried in the Tarapacá 40 cemetery and that she suffered intentional lethal lesions. Her death is unusual because there are no previous bioarchaeological records of lethal violence against women in the Tarapacá region. The osteobiography of this woman reflects a context characterized by an increase in inequality and social complexity, whereby physical violence could be used as a mechanism of internal regulation and exercise of power during the Formative period. [ABSTRACT FROM AUTHOR]

Children who experience physical and psychological maltreatment within their family are more likely to become victims of abuse outside the family. In Chinese culture, children's victimization may also be a precursor to parenting behaviors. Nevertheless, the reciprocal relationship between child maltreatment and children's bullying victimization remains unclear, particularly in Chinese culture. This study aimed to evaluate the reciprocal association between child maltreatment and children's bullying victimization in China, as well as its gender differences. A total of 891 children aged 8–11 years in China participated in the study at four time points. The potential reciprocal link was examined using a cross‐lagged model. The results indicated that physical abuse predicted children's bullying victimization across four time points, while physical neglect predicted children's bullying victimization during the first three time points. The effects of emotional abuse and neglect were negligible. Conversely, children's bullying victimization consistently predicted various types of parental maltreatment over time. Some gender differences in the relationship were found. The findings emphasized a reciprocal relationship between child maltreatment within the family and children's bullying victimization at school. Understanding the cyclical patterns between child maltreatment and bullying victimization may help improve family education approaches and reduce children's bullying victimization. [ABSTRACT FROM AUTHOR]

Childhood traumas have been considered risk factors for many psychiatric disorders. Recent studies demonstrated that childhood traumas can also be considered risk factors for neurological diseases. In this context, the objective of this study is to investigate the effects of childhood traumas on treatment resistance in patients with epilepsy. The study sample consisted of 85 epilepsy patients, 40 male and 45 female, who were diagnosed and followed up by a neurologist. Of these patients, 45 were being followed up with the diagnosis of refractory epilepsy, and 40 were being followed up with the diagnosis of treatment-responsive epilepsy. Cranial magnetic resonance imaging and electroencephalography were performed on all patients. In addition, all patients were administered childhood trauma questionnaire (CTQ) and Hamilton depression rating scale (HAM-D). Epilepsy patients included in the study were divided into refractory epilepsy and treatment-responsive epilepsy groups. There was no significant difference between the groups in sociodemographic characteristics. On the other hand, total CTQ and all CTQ subscale scores and HAM-D scores were significantly higher in the refractory epilepsy group than in the treatment-responsive epilepsy group. This study demonstrates that childhood traumas may contribute to treatment resistance in epilepsy patients. Therefore, it is recommended that a history of childhood traumas be routinely queried in the treatment of epilepsy patients. [ABSTRACT FROM AUTHOR]

The effect of abuse victimization in correctional samples has been researched previously, particularly with an eye toward these experiences on justice-involved youth and prison samples' offending and recidivism behavior. The role of this type of victimization, including physical abuse, sexual abuse, and polyvictimization, is less studied in jail populations. The effect of abuse victimization is also less researched among other outcomes, including behavioral health disorders (BHDs) and substance use disorder (SUD). While the effect of abuse, generally, has been examined, less is known about how abuse perpetrator type and timing of abuse impact justice-involved individuals' outcomes. Using logistic regressions, we examined the influence of abuse perpetrator type (non-stranger or stranger) and timing (before childhood, after childhood, or before and after childhood) in a population of jailed adults from one state (n = 4,713). Outcomes studied included internalizing BHDs, externalizing BHDs, and severe SUD. Results indicated that abuse perpetrated by a non-stranger yielded a greater impact on mental illness compared to abuse perpetrated by a stranger. In contrast to abuse experienced as an adult, childhood abuse was more consistently associated with internalizing and externalizing disorders but was not related to severe SUD, with an exception of physical abuse. Further, BHDs and SUD were strongly associated with each other. Overall, polyvictimization had the strongest effect on the outcomes compared to either physical abuse or sexual abuse alone. Our findings suggest that screening for abuse experiences as a potential destabilizing factor in justice-involved populations could improve case management and interventions for people incarcerated in jails. Results also highlight the importance of distinguishing between the perpetrator type of abuse and timing of abuse. [ABSTRACT FROM AUTHOR]

This article explores the language of rape in survivors' narratives of obstetric violence in Colombia. Obstetric violence is a type of gender violence that includes physical and psychological abuse by medical staff against patients during pregnancy, delivery, and the postpartum period. Obstetric violence, including its linguistic manifestations, is an example of reproductive injustice. Midwives and other birth activists have proposed "birth rape" to describe all medical interventions performed on women's bodies without their consent. Using data collected in Medellín, Colombia, from 17 semi-structured in-depth interviews with survivors of obstetric violence, I explain how health professionals use language to humiliate, coerce, and ignore their patients, creating childbirth experience as a traumatic, rape-like event. I discuss the phenomenological and legal implications of the concept "birth rape" in obstetric encounters and explain why some harmful practices should more accurately be labeled as "sexual violence" instead of "rape". [ABSTRACT FROM AUTHOR]

The National Elder Abuse Prevalence Study, conducted by the Australian Institute of Family Studies, was the first major national study to gauge the prevalence and nature of elder abuse in Australia. [The phrase, "conducted by the Australian Institute of Family Studies", was added to the preceding sentence on 19 October 2023, after first online publication.] A survey of older people aged 65 years and older living in private dwellings was carried out in 2020, with 7000 participants across the nation who were interviewed by telephone. The survey data suggested that 14.8 per cent of the population aged 65 and older who live in the community (rather than residential care settings) have experienced elder abuse in the past 12 months. Psychological abuse was found to be the most common subtype (11.7 per cent), followed by neglect (2.9 per cent), financial abuse (2.1 per cent), physical abuse (1.8 per cent) and sexual abuse (0.7 per cent). Interconnected with an experience of elder abuse were poorer physical health, poorer psychological health and a lower sense of social support. The findings demonstrate that elder abuse has strong familial dynamics, with perpetrators involving intergenerational and intimate partner relationships to a significant extent. Most older people who experienced elder abuse tended to manage the experience themselves—not seeking help, taking actions which would not expose the perpetrator. [ABSTRACT FROM AUTHOR]

There are growing levels of abuse toward match officials in sport as well as general problems of their recruitment and retention. Purpose: This study analyzes the role that physical and nonphysical abuse has on association football referees' intentions to quit and their personal well-being. Methods: Drawing on pooled survey data of association football referees from the UK and Canada, this paper employs probit, ordinary least squares, and treatment effects regression analyses to explore the casual relationship between the physical and nonphysical abuse faced by referees, their intention to quit and their well-being. Results: Although physical abuse is less common than nonphysical abuse both affect the intention to quit and well-being of officials. Moreover, those that do not contemplate quitting also face reductions in their well-being. Conclusion: The research recommends a zero-tolerance approach to all forms of abuse of officials in sport and identifies that organizations have a duty of care for the well-being of their officials. [ABSTRACT FROM AUTHOR]

The phenomenon of violence, which is as old as the history of humanity, continues to exist as a universal problem. Different aspects of violence also manifest themselves in the family, and with the negative effects of physical, emotional, and sexual abuse against the child, it can leave permanent traces on the child throughout their life. However, the preventable nature of child abuse makes it one of the biggest responsibilities of societies, and especially of experts working in the field, to protect children from behaviors that seriously harm their physical and mental health. All of these findings reveal the need for an urgent research study on this subject. In this study, determining the factors that are effective in child maltreatment is an important step in making prevention studies more effective. [ABSTRACT FROM AUTHOR]

Background/Aim: This study aimed to analyze the frequency and pattern of maxillofacial injuries associated with domestic violence. Materials and Methods: Medical records of victims of domestic violence between May 2016 and May 2023 were scrutinized retrospectively. The following data were analyzed: gender and age, history of previous abuse, hospital admission, pregnancy, type of facial injuries, anatomical location of injuries, side of injuries, concomitant injuries, mechanism of impact, treatment modality, and history of drug and alcohol abuse. Results: Seventy‐eight patients were included, comprising of 75 (96.2%) women and 3 (3.8%) men. Domestic violence was an etiology of 2.7% of all maxillofacial injuries. The mean age was 27.06 ± 5.5 years. 33.3% of cases had a history of previous domestic violence. The assailant was drug addicted in 47.4% of cases. The attacker was the current partner of the victim in 79.5% of the victims. Soft tissue injuries were found in 96.1% of cases. Maxillofacial fracture was observed in 52.6% of victims among which zygoma was the most common (16.7%) followed by the nose and mandible (15.4%). Isolated fracture was observed in 85.3% of patients and 71.8% of the injuries were observed on the left. Concomitant injuries were present in 51.3% of patients with arms/hands being the most frequent (48.7%). Punch (67.9%) constituted the majority of the mechanism of impact. Based on the statistical analysis, punches resulted in significantly higher soft tissue contusion (p =.046), and injuries that required no intervention were significantly higher in punched victims (p =.002). Conclusion: Maxillofacial soft tissue injuries with or without isolated fracture on the left side of the zygoma, mandibular angle, or nose in association with arms/hands injuries in young adult women could be clues of domestic violence. Appropriate care such as preventive programs for drug or alcohol abuse should be implemented to reduce domestic violence, thereby reducing these injuries. [ABSTRACT FROM AUTHOR]

Background Violence, a notable human rights concern, has a public health impact across the globe. The study aimed to determine the prevalence and determinants of domestic violence among ever-married women aged 18–49 years in India. Methods Secondary data analysis with National Family Health Survey 5, 2019–21 data (NFHS-5) was conducted. The complex sampling design of the survey was accounted-for during analysis. The primary outcome was domestic violence. Prevalence was reported with 95% confidence interval (CI). Prevalence ratio was reported to provide the factors associated with domestic violence using Poisson regression. Results About 63 796 ever-married women aged 18–49 years covered under domestic violence module of NFHS-5 survey were included. Prevalence of domestic violence (12 months preceding the survey) was 31.9% (95% CI: 30.9–32.9%). Physical violence (28.3%) was the most common form followed by emotional (14.1%) and sexual violence (6.1%). Women with low education, being employed, husband being uneducated or with coercive behavior had significantly higher prevalence of domestic violence. Conclusions One-third of the reproductive age-group women were facing some form of domestic violence. Target group interventions like violence awareness campaigns, women supportive services and stringent law enforcement should be implemented to eliminate domestic violence by year 2030. [ABSTRACT FROM AUTHOR]

El Salvador's state of emergency has been accompanied by widespread human rights violations and will result in long-term effects on the country's democracy. President Nayib Bukele has been working to expand his executive power since he won the presidential seat in 2019. The state of emergency accelerated his pursuit of consolidating power in the state, which has led to democratic backsliding. Moreover, the rapid erosion of civil liberties and physical integrity rights has expanded the gap that victims have towards accountability and protection from the excessive use of power. Nevertheless, there is still a ray of hope. International human rights activists have been paying close attention and have been documenting the abuses under the state of emergency. Victims of physical integrity abuse can seek support from the International Criminal Court. [ABSTRACT FROM AUTHOR]

Childhood adversity has been consistently linked to negative outcomes in children's mental health. Nonetheless, little is known about the lifelong effects of these experiences during a stage of development with high rates of both internalising and externalising problems: emerging adulthood. Therefore, the present study analyses the relation between self-reported exposure to a wide range of adversities in a community sample of young adults and externalising (deviant behaviour) and internalising (stress, anxiety and depression) outcomes. In this two-time prospective study, 490 young adults (62.4% females) with ages ranging from 18 to 20 years (M = 18.90) were interviewed in person first and then over an online questionnaire one year later (N = 84). Linear regressions were performed for each mental health outcome controlling for demographic variables. Physical abuse emerged as the best predictor of deviant behaviour in both time periods in a univocal relation, whereas internalising outcomes seemed to have a broader multifactorial association with distinct types of adversities only in Time 1. These findings, along with the results of the stability externalising consequences derived from physical abuse, emphasise the importance of prevention and intervention strategies to diminish the transmission of these maladaptive strategies in later periods of life. [ABSTRACT FROM AUTHOR]

Childhood maltreatment is a rising social issue worldwide. Notably, childhood maltreatment is suggested to incur non-suicidal self-injury (NSSI), which is also considered as a profound public health concern, especially among Chinese youth and adolescence. Although the relationship between the two has been reported, little is known about the roles of psychological suzhi and inferiority complex in it. The current study aimed to examine the link between childhood maltreatment and NSSI among Chinese adolescents, and determine the mediating role of inferiority complex and the moderating effect of psychological suzhi. A total of 648 students (55.6% female; Mage = 14.59) were guided to complete the self-report questionnaires regarding the mentioned study variables. Results demonstrated that childhood maltreatment was positively related with NSSI, and inferiority complex mediated such association. Furthermore, structural equation modeling (SEM) results showed that the effect of high childhood maltreatment on NSSI was weaker for adolescents who reported high psychological suzhi. In addition, the effect of inferiority on NSSI was also weaker for adolescents with high psychological suzhi. The current study demonstrated the indirect effects of inferiority complex and psychological suzhi in the link between childhood maltreatment and NSSI, advancing our understanding of the potential mechanism of such link. [ABSTRACT FROM AUTHOR]

Background: Early childhood abuse is associated with adverse effects among young adults, especially social anxiety disorder (SAD). This study investigated socio-demographic correlates of SAD among youth exposed to childhood abuse and examined different regression models among male and female youth in three childhood abuse groups, i.e. emotional abuse (EA), physical abuse (PA,) and sexual abuse (SA). Methods: A total of 117,769 young adults from 63 colleges in Jilin Province, China, participated in this cross-sectional study (from October to November 2021). Childhood abuse and SAD were measured by the Childhood Trauma Questionnaire-Short Form (CTQ-SF) and the social anxiety subscale of the self-consciousness scale (SASS-CS). Analyses were conducted to examine the relationship between childhood abuse and SAD, as well as the demographic correlates of SAD among male and female youth exposed to three forms of childhood abuse. Results: First, significant and positive relations were found between different forms of childhood abuse (EA, PA, SA) and SAD (p <.001). Second, subjective socioeconomic status and relationship with father/mother were associated with SAD in three childhood abuse groups (p <.001). When dividing these participants by gender, apart from the above factors, male participants from single-parent families, living in rural areas and with a lower father's educational level were associated with higher SAD (p <.05). In contrast, female participants from left-behind and reconstituted families were also associated with higher SAD (p <.05). Conclusions: Several demographic correlates are vital for developing prevention efforts and reducing the incidence of SAD among college students exposed to childhood abuse. Existing policies, programs, and practices should be strengthened and new evidence-based ones should be developed for the primary prevention of SAD among these youth. [ABSTRACT FROM AUTHOR]

Improved prediction of physical child abuse could aid in developing preventive measures. Parental physical disease has been tested previously as a predictor of documented physical child abuse but in broad categories and with differing results. No prior studies have tested clinically recognizable categories of parental disease in a high-powered dataset. Using Danish registries, data on children and their parents from the years 1997–2018 were used to explore several parental physical disease categories' associations with documented physical child abuse. For each disease category, survival analysis using pseudovalues was applied. When a parent of a child was diagnosed or received medication that qualified for a category, this family and five comparison families not in this disease category were included, creating separate cohorts for each category of disease. Multiple analyses used samples drawn from 2,705,770 children. Estimates were produced for 32 categories of physical diseases. Using Bonferroni-corrected confidence intervals (CIc), ischemic heart disease showed a relative risk (RR) of 1.44 (CIc 1.13–1.84); peripheral artery occlusive disease, RR 1.39 (CIc 1.01–1.90); stroke, RR 1.19 (1.01–1.41); chronic pulmonary disease, RR 1.33 (CIc 1.18–1.51); ulcer/chronic gastritis, RR 1.27 (CIc 1.08–1.49); painful condition, 1.17 (CIc 1.00–1.37); epilepsy, RR 1.24 (CIc 1.00–1.52); and unspecific somatic symptoms, RR 1.37 (CIc 1.21–1.55). Unspecific somatic symptoms were present in 71.87% of families at some point during the study period. Conclusion: Most parental physical disease categories did not show statistically significant associations, but some showed predictive ability. Further research is needed to explore preventive potential. What is Known: • Few and broad categories of parental physical disease have been examined as risk factors for severe physical child abuse; no prior study has used several categories as predictors. What is New: • Unspecific symptoms, ischemic heart disease, peripheral artery occlusive disease, stroke, chronic pulmonary disease, stomach ulcer/chronic gastritis, painful condition, and epilepsy all showed to be potential predictors, with unspecific symptoms being the most prevalent. [ABSTRACT FROM AUTHOR]

Objective: Cannabis use among veterans in Canada is an understudied public health priority. The current study examined cannabis use prevalence and the relationships between child maltreatment histories and deployment-related traumatic events (DRTEs) with past 12-month cannabis use including sex differences among Canadian veterans. Method: Data were drawn from the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (response rate 68.7%; veterans only n = 1,992). Five child maltreatment types and 9 types of DRTEs were assessed in relation to the past 12-month cannabis use. Results: The prevalence of lifetime and past 12-month cannabis use was 49.4% and 16.7%, respectively. Females were less likely than males to report lifetime cannabis use (41.9% vs. 50.4%; odds ratio [OR] 0.71; 95% CI, – 0.59 to 0.86). No sex differences were noted for past 12-month cannabis use (14.1% vs. 17.0%; OR 0.80; 95% CI, 0.60 to 1.07). Physical abuse, sexual abuse, neglect, any child maltreatment, most individual DRTEs, and any DRTE were associated with increased odds of past 12-month cannabis use after adjusting for sociodemographic and military variables. Some models were attenuated and/or nonsignificant after further adjustments for mental disorders and chronic pain conditions. Sex did not statistically significantly moderate these relationships. Cumulative effects of having experienced both child maltreatment and DRTEs compared to DRTEs alone increased the odds of past 12-month cannabis use. Statistically significant interaction effects between child maltreatment history and DRTE on cannabis use were not found. Conclusions: Child maltreatment histories and DRTEs increased the likelihood of past 12-month cannabis use among Canadian veterans. A history of child maltreatment, compared to DRTEs, indicated a more robust relationship. Understanding the links between child maltreatment, DRTEs, and cannabis use along with mental disorders and chronic pain conditions is important for developing interventions and improving health outcomes among veterans. [ABSTRACT FROM AUTHOR]

This study aimed to assess the prevalence of adverse childhood experiences and their relationship with self-esteem among secondary school students in Jordan. A cross-sectional, retrospective design was utilized using a convenience sample of 559 secondary school children (grades 7–11). Results showed that among the participating students, emotional abuse was the most commonly reported type of abuse (59.6%), followed by household violence (52.2%), bullying (44.7%), physical abuse (31.7%), emotional neglect (26.3), physical neglect (12.7%), and parents' separation (5.2%). Male students reported significantly more physical abuse than female students (37.5% vs 26.2%, p < 0.001), and significantly more physical neglect than female students (18.2% vs 7.6%, p < 0.001). However, female students reported significantly more household violence than male student (60.0% vs 43.9%, p < 0.001). Self-esteem scores were lower for students who reported physical abuse (d = 0.38, p < 0.001), household violence (d = 0.25, p < 0.003), emotional neglect (d = 0.45, p < 0.001), physical neglect (d = 0.58, p < 0.001), and bullying (d = 0.29, p = 0.001). Self-esteem was best predicted by physical abuse (β = − 0.114, p = 0.009), emotional neglect (β = − 0.169, p < 0.001), and physical neglect (β = − 0.148, p < 0.001). Efforts should be exerted to prevent violence against children. National programs and community awareness campaigns should focus on the violence's detrimental effects on children. [ABSTRACT FROM AUTHOR]

Childhood maltreatment is the strongest predictor of psychopathology and personality disorders across the lifespan and is strongly associated with a variety of psychological problems, namely, mood and anxiety disorders, behavioral and personality disorders, substance abuse, aggression, and self-harm. In this study, we aim to provide a comprehensive picture of the interplay between different traits of psychopathy and distinct dimensions of childhood maltreatment, emotion regulation, and aggression. Using a cross-sectional design, we employed correlational network analysis to explore the nomological network of psychopathy and provide a sample-based estimate of the population parameters reflecting the direction, strength, and patterns of relationships between variables. The sample consisted of 846 adults (71% females) who completed questionnaires measuring psychopathy, childhood maltreatment, emotion regulation, and aggression. The results highlight that disinhibition traits of psychopathy are the closest attributes of early experiences of abuse (but not neglect) in childhood and correlate with all dimensions of emotion regulation difficulties, being specifically associated with reactive aggression. Neglect was a unique attribute in the nomological network of meanness, with widespread correlations with emotion regulation difficulties but also an increased ability to engage in goal-directed behavior. Physical abuse was the only dimension of childhood adversity that was found to be intercorrelated with boldness and increased emotional regulation was found in this psychopathic trait. No significant associations were found between boldness, meanness, and aggression once shared variance with disinhibition was controlled. These results are discussed in terms of their implication for research and clinical practice. [ABSTRACT FROM AUTHOR]

Programmes based on social emotional learning (SEL) have been effective in reducing psychosocial difficulties in a number of countries. In Mainland China, there has been no empirical research on the prevention of children's psychosocial difficulties using the SEL approach. This study aimed to assess whether an adapted version of the SEL programme can reduce psychosocial difficulties of primary school children in rural China. The intervention consisted of 16 weekly 90‐min class sessions, conducted among 206 children aged 8–12 years (with 290 controls) in a poor rural area of Central China. Self‐report questionnaires were administered at baseline, post‐intervention and 5‐month follow‐up. The results suggested that the programme (1) can reduce children's total difficulties (measured using the Strength and Difficulties Questionnaire) at post‐intervention (d = −0.18) and 5‐month follow‐up (d = −0.19), (2) was more effective among children experiencing verbal abuse (d = −0.21) or physical abuse (d = −0.24) from caregivers and (3) was popular among more than 90% of the participants. The programme is cheap, easy to implement and can be delivered in school hours. Therefore, it has clear potential for replicability and sustainability. [ABSTRACT FROM AUTHOR]

The second case in the Safeguarding Essentials in Modern-day Paediatrics series, this article focuses on inflicted injuries, body maps and child protection investigations (CPIs). Using the scenario of a 6-year-old presenting to the emergency department having 'fallen off a swing', this article focuses on key considerations for history taking and examination in cases where you suspect injuries may have been inflicted, and how to discuss raising these suspicions with the family, as well as the importance of accurate body map completion. Also covered are CPIs, giving consideration to the legal framework surrounding these, and relevant useful resources and guidance are provided for dealing with the challenging circumstances that arise when physical abuse is first suspected. [ABSTRACT FROM AUTHOR]

Recent empirical literature has focused on the social aspect of gender-based violence regarding domestic violence and physical abuse while the implications of economic empowerment in an attempt to reduce gender-based violence remain under-researched. This study investigated the connection between female economic empowerment and factors that could reduce gender-based violence in sub-Saharan African countries. We used the panel fully modified least squares estimation method to investigate the long-run implications. The gender inequality index, the female genital mutilation prevalence, and the number of female children out of school were used as proxies for gender-based violence. Likewise, economic empowerment was a proxy for female economic participation; it was replaced by female employment for the robustness test. Evidence from the panel fully modified least squares estimation showed that female economic empowerment had a negative relationship with the gender inequality index, the number of female children out of primary school, and female genital mutilation. We concluded that an increase in the economic power of females through increased economic participation could reduce gender-based violence in the long run. Based on these findings, this study recommends policies to improve the situation. This study shifts attention to the macro-connection between factors that can reduce GBV and increase female economic empowerment in selected areas of sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Background: Studies have investigated how adults with severe depressive symptoms are more likely to attempt suicide, and these adults often have traumatic experiences and chaotic sleep/wake rhythms. Thus, this study using Latent class analysis aimed to investigate the relationship between childhood trauma class, chronotype, and suicide attempts among emerging adults with severe depressive symptoms. Methods: This study was conducted among emerging adults with severe depressive symptoms covering 63 Universities in Jilin Province, China. A total of 1,225 emerging adults (mean age = 19.6 ± 1.78) constructed the final sample. In addition to measuring socio-demographic characteristics, the Childhood Trauma Questionnaire-Short Form, the Single-Item Chronotyping, and a single item for suicide attempts were used to evaluate childhood trauma, chronotype, and suicide attempts, respectively. Latent class analysis was applied to identify the classes of childhood trauma within emerging adults who had severe depressive symptoms. Hierarchical logistic regression models were run to investigate the effects of socio-demographic characteristics, chronotype, and childhood trauma class on suicide attempts. Results: Three latent classes were identified: the Low-risk for childhood trauma class, the Neglect class, and the High-risk for childhood abuse class. Those who suffered sexual, emotional, and physical abuse at the same time were divided into the High-risk for childhood abuse class, and were significantly more likely to experience suicide attempts than those in the Neglect class (OR = 1.97, 95%CI = 1.34–2.89, p < 0.001) and the Low-risk for childhood trauma class (OR = 2.28, 95% CI = 1.50-3.46, p < 0.001). In terms of chronotype, the results showed that the chaotic type was a risk factor for suicide attempts when compared with the evening type (OR = 0.46, 95%CI = 0.27–0.78, p < 0.01), the moderately active type (OR = 0.53, 95%CI = 0.31–0.89, p < 0.05), and the daytime type (OR = 0.42, 95%CI = 0.21–0.86, p < 0.05). Overall, the significant risk factors for suicide attempts included being female, living in an urban area, having experienced sexual, emotional, and physical abuse simultaneously, and having a chaotic chronotype. Conclusion: Emerging adults suffering sexual, emotional, and physical abuse at the same time and identifying with chaotic chronotype showed a higher risk of attempting suicide. The findings provided a clinical reference to quickly identify those at high risk of suicide attempts among emerging adults with severe depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: Childhood maltreatment is a risk factor for developing multiple forms of psychopathology, including depression, posttraumatic stress disorder (PTSD), and anxiety. Yet, the mechanisms linking childhood maltreatment and these psychopathologies remain less clear. Objective: Here we examined whether self-stigma, the internalization of negative stereotypes about one’s experiences, mediates the relationship between childhood maltreatment and symptom severity of depression, PTSD, and anxiety. Methods: Childhood trauma survivors (N = 685, Mage = 36.8) were assessed for childhood maltreatment, self-stigma, and symptoms of depression, PTSD, and anxiety. We used mediation analyses with childhood maltreatment as the independent variable. We then repeated these mediation models separately for childhood abuse and neglect, as well as the different subtypes of childhood maltreatment. Results: Self-stigma significantly mediated the relationship between childhood maltreatment and depression, PTSD, and anxiety symptoms. For sexual abuse – but not physical or emotional abuse – a significant mediation effect of self-stigma emerged on all symptom types. For childhood neglect, self-stigma significantly mediated the relationship between both emotional and physical neglect and all symptom types. Conclusion: Our cross-sectional study suggests that different types of childhood maltreatment experiences may relate to distinct mental health problems, potentially linked to increased selfstigma. Self-stigma may serve as an important treatment target for survivors of childhood abuse and neglect. [ABSTRACT FROM AUTHOR]

Much of the literature on domestic abuse focuses on those in intimate partner relationships or ex-partners, however, in the UK the Home Office definition also includes those in familial relationships. The Domestic Abuse, Stalking, and Harassment and Honour-Based Violence Risk Assessment assumes homogeneous risk factors across all relationships. This paper therefore examines the risk factors for repeat victimization of domestic abuse by relationship type between the victim and perpetrator in a UK police force. Using police-recorded domestic abuse incident and crime data, a logistic regression model found that the most similar repeat victimization risk profiles for 14,519 victims were amongst partners and ex-partners, with both relationships demonstrating the greatest degree of gender asymmetry, compared with other familial relationships. Physical violence was the strongest predictor of repeat victimization and was a statistically significant predictor for ex-partners, partners, and all familial relationships. Coercive behaviour was also a significant predictor for all relationships apart from partners, but not at the same magnitude as physical abuse. Recognizing the difference in risk by relationship type may assist the police in deciding the most appropriate response and interventions to reduce the risk of further harm. [ABSTRACT FROM AUTHOR]

Background: Complications of surgical clitoral reconstruction for female genital mutilation/cutting (FGM/C) are a rare occurrence, but there has been reports of patients experiencing chronic pain or clitoral burial. Aim: This study aims to assess which factors are predictive of the occurrence of surgical complications in women who had surgical reconstruction for FGM/C (type 1, 2, or 3). Methods: This monocentric retrospective study was conducted among patients who underwent clitoral reconstruction after FGM/C from January 2016 to March 2020. Demographic and clinical data were abstracted from the medical records. Outcomes: The primary outcome was the occurrence of chronic pain (defined as occurrence or persistence of any clitoral pain >3 months after surgery), and the secondary outcome was the occurrence of clitoral burial. Results: A total of 87 women were included in the analysis. Univariate analysis indicated significantly higher rates of a history of physical abuse in the group of women who experienced chronic pain after surgery (4 [100%] vs 2 [37.1%], P = .049). Patients with clitoral burial were significantly younger than the rest of the sample in univariate analysis (median [IQR], 29.6 years [24.6-30.2] vs 33.8 [28.2-37.9]; P = .049). Clinical Implications: Surgical treatment of women who underwent FGM/C should include the entire history of the patient and especially a record of experiencing physical abuse. Strengths and Limitations: The study stands out for its originality, the extensive sample size gathered over nearly 4 years, the surgical clitoral reconstructions conducted by an experienced surgeon, and the minimal amount of missing data. However, because the occurrence of these complications was rare, the number of patients in the subgroups was extremely low, preventing a valid multivariate analysis to be conducted. Conclusion: The study suggests that women with a history of physical abuse could be at greater risk for chronic pain after surgery and that younger women tend to experience more clitoral burial. [ABSTRACT FROM AUTHOR]

Successful prevention of physical child abuse is dependent on improvements in risk assessment. The risk of abuse is assumed to increase when family stressors overcome resources. Severe physical disease can increase stress, and parental physical disease has been studied as a risk factor for physical child abuse, but with heterogeneous definitions. This study evaluated the relation between parental physical disease severity and severe documented physical child abuse. Models were based on data on children aged 0–17 years in Denmark between 1997 and 2018, and their parents. Severe documented physical child abuse was modeled as violence against a child registered by either health authorities in treatment or mortality registries, or police authorities in cases confirmed by the courts. Parental physical disease severity was modeled as the sum of Charlson Comorbidity Index scores for the child's parents. The causal connection was examined in two model types: a survival model comparing exposed with non-exposed children, adjusted for covariates at baseline, and a G-model, taking time-varying covariates, including income and parental psychiatric disease into account. Neither model showed an association between parental physical disease severity and severe documented physical child abuse, with RR 0.99 and 95% CI (0.93–1.05) for the survival model and RR 1.08 for the G-model (CI not calculated). Conclusion: In the model studied, parental physical disease severity was not a risk factor for severe documented physical child abuse. Individual categories of physical disease remain to be examined. Trial registration: The study was pre-registered on Open Science Framework, https://osf.io/fh2sr. What is Known: • Parental physical disease severity has been studied previously as a risk indicator of physical child abuse, but based on heterogeneous definitions. • Previous studies have not studied parental physical disease severity preceding physical child abuse. What is New: • Parental severe physical disease was not prospectively associated with severe documented physical child abuse in a survival model, a G-model and a number of sensitivity analyses, respectively. • Results should be replicated in samples from populations without universal health care, and using different categories of disease. [ABSTRACT FROM AUTHOR]

All unexpected deaths of children require an autopsy to determine the cause of death. In cases of aortic rupture, the immediate cause of death is easily identified at autopsy. Although the majority of aortic ruptures are caused by high-energy trauma, other causes should not be missed. We present and discuss the case of a 29-month-old child who died suddenly at home. Her recent medical history and the ecchymotic lesions observed on external examination of the body appeared potentially suspicious of physical abuse. The autopsy concluded that death was due to complete rupture of the abdominal aorta with associated vertebral disjunction. At first glance, the overall forensic picture could suggest a traumatic death. However, careful inspection of the retroperitoneum revealed a discrete atypical mass of infiltrative tissue within the hematoma. Histopathological examinations confirmed tumor proliferation of the soft tissues, triggering vascular and spinal injuries. Other paraneoplastic elements or metastases were ultimately revealed (orbital and subcutaneous). Overall, this was a rare and fatal case of abdominal aortic rupture induced by tumors. Due to the mechanisms and the forces needed to cause vertebral dislocations and aortic rupture, the combination of the two is highly suggestive of child abuse when an accidental traumatic history is absent or inconsistent with the injuries. Nevertheless, this case illustrates the importance of a systematic and rigorous forensic examination, rather than ignoring other possible diagnoses. [ABSTRACT FROM AUTHOR]

It is well-established that disrupted autonomic nervous system (ANS) reactivity exacerbates risk for long-term maladjustment following childhood adversity (CA). However, few studies have integrated measures of both the sympathetic (SNS) and parasympathetic (PNS) branches of the ANS, resulting in a unidimensional understanding of ANS functioning as a mechanism of risk. Further, past work has primarily measured CA only at the aggregate level (e.g. "total CA"), necessitating further research to accurately characterize this risk pathway. The present study examines how CA, measured cumulatively and dimensionally (i.e. CA characterized by threat versus deprivation), moderates the association between the SNS and PNS at rest and in response to acute social and nonsocial stressors. Participants included 97 adolescents ages 10-15 (Mage = 12.22, SDage = 1.68) experiencing a range of CA and one accompanying caregiver. Participants completed questionnaires assessing prior CA exposure. SNS and PNS responses were then continuously measured during rest and two stress tasks. First, results indicate a blunting effect of cumulative CA and CA characterized by threat (e.g. physical abuse) on resting SNS activity. Second, in moderation analyses assessing ANS coordination, threat exposure emerged as a significant moderator of the association between SNS and PNS reactivity to social stress. Results suggest that CA characterized by threat may specifically impact physiologic regulation by disrupting the coordination of the two branches of the ANS. Disentangling the independent and concurrent engagement of biological stress response systems following CA remains an important target for research to identify the etiology of aberrant stress reactivity patterns. [ABSTRACT FROM AUTHOR]

Evidence describing age‐related differences among children with suspected physical and sexual child abuse is lacking. We describe findings in severe cases of suspected abuse. Cases with 756 children <15 years old were included during 2001–2013 at the Department of Forensic Medicine, Aarhus University, using forensic evaluation documents, medical records, and court proceedings. Eight percent of children <4 years old died from child abuse, 36% through violence resulting in death, and 64% by manslaughter, whereas 1% > 4 years old died, solely by manslaughter. External injuries were mainly located to head and torso in children <4 years old, changing to the upper and lower extremities in older children. Child sexual abuse was suspected in 52% of cases with living children <4 years old, 83% of children 4–7 years of age, 88% of children 8–11 years of age, and 93% of children >12 years old. Anogenital findings were mainly caused by other medical conditions in children <4 years old, hymenal clefts in the superior half of the hymenal rim were almost exclusively found in children between 8 and 11 years of age, whereas both superficial and complete hymenal clefts in the inferior half of the hymenal rim were found in children >12 years old. The present study describes age‐related differences in victims of suspected child abuse. Fatal versus nonfatal child physical abuse and the significance of hymenal findings in child sexual abuse could be studied further. [ABSTRACT FROM AUTHOR]

The unsustainable power imbalance between corporations and their employees has resulted in the physical and emotional abuse of workers. This power disparity has existed for decades. Congress has stepped in on several occasions to address the problem. Workplace law is at another apex where the power disparity between companies and employees has grown too large. The current failure of our political system has left Congress unable to act. A different approach to workplace power is necessary, and this Article offers a much-needed proposal that addresses existing employer abuses. [ABSTRACT FROM AUTHOR]

Economic abuse involves behaviors that control a woman's ability to acquire, use, and maintain economic resources, thus threatening her economic security and potential for self-sufficiency (Adams, Sullivan, Bybee, & Greeson, 2008). Woman battering is a prevalent social problem committed against millions of women each year. Battering involves psychological abuse, physical abuse, and economic abuse as well. Economic abuse is the area which is less focused as compared to other forms of battering. The objective of present study was to develop an indigenous scale that would explore the phenomenon of economic abuse faced by married Pakistani women as currently there is no such indigenously developed measure of economic abuse available in Pakistan. Present study was conducted in two phases. In the first phase, a pool of items was generated. In phase two, Content Validity for EAS was established. The Scale CVI was 0.93. All 41 items were retained and were transformed into a 5-point rating scale. The psychometric properties of scale will be established using factorial validity. [ABSTRACT FROM AUTHOR]

Adolescent pregnancy has been on the rise in developing countries, primarily attributed to economic challenges, particularly in Africa and South Asia. West Java Province stands out as one of the leading regions with a high incidence of adolescent pregnancies. Young couples often struggle to adapt to early marriage, resulting in domestic violence and adverse health consequences. Notably, domestic violence is prevalent among young married couples, with Bogor reporting a significant incidence among pregnant adolescents. Mothers play a crucial role in providing protection and resolving domestic issues. This study aimed to investigate mothers' perspectives on domestic violence towards adolescents and their problem-solving strategies. The study employed qualitative methods with a descriptive interpretation approach. Data were gathered through in-depth interviews with seven mothers whose daughters had experienced domestic violence by their husbands during pregnancy, having given birth and entered marriage. Thematic content analysis was employed for data analysis. The central finding is that economic challenges serve as the primary catalyst for domestic violence, manifesting through harsh language and physical abuse, leading to potential harm to the child and miscarriage. Pregnant adolescents often experience psychological distress, exhibiting symptoms such as daydreaming, sadness, crying, and weight loss. Mothers express concern about the domestic violence their daughters endure during pregnancy, attributing it to economic issues. To address the problem, mothers employ various strategies, including seeking advice, providing emotional support, involving health services, mediating, communicating, and reporting incidents to relevant authorities. Maternity nurses should proactively offer information about the risks associated with adolescent pregnancies and early marriage. The government must actively communicate the significance of the risk of early pregnancy, particularly concerning violence, to teenagers. [ABSTRACT FROM AUTHOR]

Burn-related child abuse represents a critical global health concern, accounting for 180,000 deaths each year, primarily in low- and middle-income countries. Children under five years of age from low-income households are especially at risk, influenced by a range of family-related factors. The severity of burns is frequently associated with suspected abuse, leading to significant emotional trauma. Healthcare providers must improve the use of screening tools to effectively identify instances of abuse. A comprehensive approach that includes prevention, early detection, and targeted interventions is essential for mitigating child abuse and reducing burn injuries. [ABSTRACT FROM AUTHOR]

Background: It has been shown that the course of COVID-19 infection in the under-18 population was in many cases sparsely symptomatic. In contrast, the impact of the pandemic on the psychological state is quite different. The risk of psychopathological symptoms in children and adolescents increased and the course of already present psychiatric disorders has often been exacerbated. Objectives: Thus, this study aimed to evaluate the prevalence of psychological and physical violence among children and adolescents and its change during the COVID-19 pandemic, as well as to investigate various factors that might affect violence. Methods: In this survey study, 782 responses were included, with 480 collected during the second and 302 during the fourth wave of COVID-19. In this cross-sectional study, an anonymous questionnaire was used to collect demographic data, medical history, mental state, psychopathological symptoms, as well as the presence of psychological, physical violence, and suicidal self-harm behaviors before (retrospectively) and during the COVID-19 pandemic in the under-18 population of the Lodz Voivodship. The survey was prepared using Google Forms. Results: A decrease in the prevalence of physical violence during both waves of the pandemic has been observed (6.39% vs. 3.45%; p < 0.001), with only a similar trend present for psychological violence 16.75% vs. 14.71%; p = 0.081). No difference between physical and psychological violence was present in different pandemic waves, type of flat or house individuals lived in, availability of one's room, number of people living in the house, number of siblings, and type of school classes (p > 0.050). Older children (>15 years old) were more likely to be victims of psychological violence before and during the pandemic (both p < 0.001). A statistically significant model was obtained for psychological violence before (p < 0.001, R2 = 0.011) and during the pandemic (p = 0.007, R2 = 0.032). Risk factors for psychological violence before the pandemic included male gender (B = 0.531, p = 0.009, OR = 1.700), older age (B = 0.869, p = 0.001, OR = 2.385), and smaller city size (B = −0.187, p = 0.004, OR = 0.829), while for psychological violence during the pandemic, the risk factors were only male gender (B = 0.482, p = 0.022, OR = 1.620) and older age (B = 0.555, p = 0.046, OR = 1.742). No statistically significant models were created for physical violence (p > 0.050). Conclusions: The observed decrease in physical violence during the COVID-19 pandemic suggests that in the studied group, home environment was not the main source of physical violence. Yet, we did not find any predicting factors for this form of violence. Violence, both physical and psychological, is a dangerous phenomenon in the under-18 population both in the pre-pandemic period and in crisis situations such as the pandemic. [ABSTRACT FROM AUTHOR]

This document contains abstracts from the 15th International Conference on Child and Adolescent Psychopathology (ICCAP 2023), covering a range of topics related to child and adolescent mental health and development. The abstracts provide valuable insights into various aspects of child and adolescent psychology and can be useful for researchers and practitioners in the field. Some of the topics explored include parenting practices, adolescent mental health, foster parents' coping with grief, social and emotional development, discipline methods, parent-child activities, sensorimotor patterns in children with Down syndrome, paternal postnatal depression, adverse childhood experiences, domestic and family violence, sibling sexual abuse, child trafficking, dissociation and childhood trauma, self-harm among adolescents, and cyberbullying. The articles discuss the increased risk of suicidal behavior among secondary school adolescents in the post-pandemic period, the impact of maternal emotional distress on adolescent sons, knowledge and attitudes regarding child abuse and neglect, cyberbullying in Indonesia, callous-unemotional traits and conduct problems, HPV vaccination decision-making, parental stress in Type 1 diabetes mellitus, and digital entrepreneurship education for kindergarten children. [Extracted from the article]

Child torture is a worldwide problem, but there is very little research on torture as a form of child abuse. In 2014 Knox et al. reported the first case series on child torture and developed criteria to diagnose child abuse torture. Our objective was to describe additional child abuse torture victims and to determine whether they shared similar patterns, including types of abuse, duration and possible opportunities for early identification. This multi‐site case series reviewed 47 children identified as torture victims at three Washington State child abuse programs spanning 15 years. Data was collected through retrospective chart review. Simple descriptive statistics were utilised. Our study found that abuse occurred over months to years. All children experienced psychological maltreatment, 89 per cent had findings of physical abuse. Malnutrition and medical, emotional and educational neglect were common. Majority of torture victims had previously been involved with CPS or had seen a medical provider prior to diagnosis, at which time they had findings of torture, but received no protective intervention. It's important to develop criteria for recognition and early intervention since tortured children experienced sustained, systematic and escalating abuse. [ABSTRACT FROM AUTHOR]

Parenting programs are the most common intervention for preventing the lethal form of child maltreatment, abusive head trauma (AHT). However, certain results of the effects of these programs have not yet been compared across studies. A systematic review with meta-analysis is warranted to quantitively synthesize the available evidence to identify effective elements and strategies of the programs for preventing AHT. This review aims to estimate AHT preventive parenting programs' pooled effect on the reduction of AHT incidence, the improvement of parental knowledge, and the increased use of safe strategies in response to infants' inconsolable crying. Studies published in English and Mandarin were searched and retained if they were randomized control trials (RCTs) or with a quasi-experimental design, included an AHT preventive parenting program, and provided data that quantified targeted outcomes. Eighteen studies were included in this review. AHT preventive parenting programs had a pooled effect on improving parents' knowledge and increasing the use of safe coping strategies in response to inconsolable crying but not on the incidence of AHT and parents' emotional self-regulation. Subgroup analyses showed that the intervention effects were mostly present across study designs or measurements and emerged in the reduction of AHT incidence compared with historical controls. The findings suggest that AHT preventive parenting programs enhance parenting knowledge and skills to provide safe care for infants. Further efforts to evaluate AHT parenting programs on the reduction of AHT incidence are necessary for decision-making on allocating and disseminating interventions. [ABSTRACT FROM AUTHOR]

Health professionals play a significant role in identifying and reporting child physical abuse (CPA). However, several studies have pointed out non-reporting behavior among these professionals, evidencing difficulties identifying and reporting suspected cases. This review aimed to explore the frequency and possible barriers in identifying and reporting CPA by health professionals worldwide and to identify associated factors. This scoping review was conducted in the Pubmed, Web Of Science, Scopus, and SciELO databases between July 2019 and December 2020. Analytical and qualitative observational epidemiological studies were selected and published in English, Portuguese, and Spanish, with data on the identification and/or reporting of CPA by health professionals. Twenty studies fulfilled the criteria of this review. The studies were conducted with dentists, nurses, pediatricians, and general practitioners. The frequency of identification of CPA ranged from 50% to 89%, while the frequency of reporting ranged from 8% to 47%. This review revealed that health professionals had a low frequency of reporting of CPA, especially for dentists. In addition, several associated factors and barriers in the identification and reporting of CPA were identified in the studies. These were discussed in five main themes: training and continuing education in CPA, impact on professional practice, experiences and perceptions about child protection services, the threshold for suspicion of the professional, and the professional category. [ABSTRACT FROM AUTHOR]

Background: Numerous strategies for preventing abusive head trauma (AHT) have been proposed, but controlled studies failed to demonstrate their effectiveness. Digital tools may improve the effectiveness of AHT prevention strategies by reaching a large proportion of the adult population. Objective: This study aimed to describe the characteristics of videos of AHT prevention published on the internet, including their quality content, and to study their association with popularity. Methods: From a systematic appraisal performed in June 2023, we identified videos addressing the primary prevention of AHT in children younger than 2 years that were published in English or French on the internet by public organizations or mainstream associations. We analyzed the characteristics of the videos; their quality with the Global Quality Scale (GQS); and their association with an index of popularity, the Video Power Index, using multivariable quasi-Poisson modeling. Results: We included 53 (6.6%) of the 804 videos identified. Videos were mainly published by public organizations (43/53, 81%). The median time spent on the web was 6 (IQR 3-9) years, the median length was 202 (IQR 94-333) seconds, and the median GQS score was 4 (IQR 3-4). Infants were often depicted (42/53, 79%), including while crying (35/53, 66%) and being shaken (21/53, 40%). The characterization of shaking as an abuse and its legal consequences were cited in 47% (25/53) and 4% (2/53) of videos, respectively. The main prevention strategies in the videos were to raise awareness of the noxious outcome of shaking (49/53, 93%) and convince viewers of the effectiveness of coping strategies for infants' cries (45/53, 85%). The Video Power Index was positively correlated with the GQS (r =0.38; P =.007) and was independently associated with depicting an infant being shaken (P =.03; β=1.74, 95% CI 1.06-2.85) and the use of text or headers (P =.04; β=2.15, 95% CI 1.08-4.26). Conclusions: AHT prevention videos had high quality but did not frequently deal with parental risk factors. The characteristics identified as being associated with the popularity of AHT prevention videos could help improve the impact of future prevention programs by enhancing their popularity. [ABSTRACT FROM AUTHOR]

Background: Despite the impact of physical abuse on children, it is often underdiagnosed, especially among children evaluated in emergency departments (EDs). Electronic clinical decision support (CDS) can improve the recognition of child physical abuse. Objective: We aimed to develop and test the usability of a natural language processing–based child abuse CDS system, known as the Child Abuse Clinical Decision Support (CA-CDS), to alert ED clinicians about high-risk injuries suggestive of abuse in infants' charts. Methods: Informed by available evidence, a multidisciplinary team, including an expert in user design, developed the CA-CDS prototype that provided evidence-based recommendations for the evaluation and management of suspected child abuse when triggered by documentation of a high-risk injury. Content was customized for medical versus nursing providers and initial versus subsequent exposure to the alert. To assess the usability of and refine the CA-CDS, we interviewed 24 clinicians from 4 EDs about their interactions with the prototype. Interview transcripts were coded and analyzed using conventional content analysis. Results: Overall, 5 main categories of themes emerged from the study. CA-CDS benefits included providing an extra layer of protection, providing evidence-based recommendations, and alerting the entire clinical ED team. The user-centered, workflow-compatible design included soft-stop alert configuration, editable and automatic documentation, and attention-grabbing formatting. Recommendations for improvement included consolidating content, clearer design elements, and adding a hyperlink with additional resources. Barriers to future implementation included alert fatigue, hesitancy to change, and concerns regarding documentation. Facilitators of future implementation included stakeholder buy-in, provider education, and sharing the test characteristics. On the basis of user feedback, iterative modifications were made to the prototype. Conclusions: With its user-centered design and evidence-based content, the CA-CDS can aid providers in the real-time recognition and evaluation of infant physical abuse and has the potential to reduce the number of missed cases. [ABSTRACT FROM AUTHOR]

Objective: To review the literature unprecedentedly to identify the dentistry students' knowledge of pediatric patients who suffered violence. Material and Methods: A systematic review was conducted using PubMed, Web of Science, LILACS, SciELO, Google Scholar, and OpenGrey electronic databases up to November 2021. The "Grey Literature" was verified through Google Scholar and Open Grey searches to avoid any selection bias. There was no restriction on the date of publication or language. Results: The systematic search yielded 2.756 studies in the first selection phase, but only twenty-two articles were included. All selected articles were published between 1998 and 2021 and used a questionnaire to evaluate the dentistry students' knowledge regarding child maltreatment cases. Brazil was the country that had the most studies included (10 articles). Despite the majority of the students presenting insufficient knowledge about child maltreatment, evidence from this research showed that every form of approach by professionals toward child maltreatment should be considered important. Conclusion: Therefore, there are deficiencies regarding the teaching-learning methodology, reinforcing the need for improvements in Dentistry undergraduate curricula. [ABSTRACT FROM AUTHOR]

Objective: Obesity and substance use are leading preventable causes of mortality, yet their origins in violence remain poorly understood. This study examined child maltreatment in relation to obesity and symptoms consistent with substance use disorder (SUD) in late adolescence, determining the roles of the child maltreatment type and timing, and gender. Method: The sample (N = 1,161) was drawn from the Longitudinal Studies of Child Abuse and Neglect. Obesity and SUD were measured at 18 years. Lifetime child protective services records and youth self-reports indicated physical abuse, sexual abuse, supervisory neglect, failure-to-provide neglect, and emotional maltreatment during early childhood, middle childhood, and adolescence. Results: In the overall sample, emotional maltreatment during adolescence was associated with obesity (OR = 2.03, 95% CI [1.25, 3.30]) and SUD (OR = 2.00, 95% CI [1.20, 3.35]), and adolescent physical abuse with obesity (OR = 2.20, 95% CI [1.36, 3.58]). In girls, early childhood physical abuse was associated with SUD (OR = 2.35, 95% CI [1.08, 5.12]), and emotional maltreatment during adolescence with obesity (OR = 2.16, 95% CI [1.10, 4.23]) and SUD (OR = 3.21, 95% CI [1.37, 7.3 5]). Adolescent physical abuse and obesity were associated in boys (OR = 3.18, 95% CI [1.45, 6.98]). Gender moderation was identified for an inverse relationship between supervisory neglect and obesity in girls (OR =.26, 95% CI [.07,.99]). Conclusions: Type and timing contribute to the effects of child maltreatment, contingent upon gender. Intervention focused on adolescent emotional maltreatment may reduce both SUD and obesity. [ABSTRACT FROM AUTHOR]

The study examined the prevalence and predictors of physical abuse of women in Uganda and Malawi. The Demographic Health Survey in the Integrated Public Use Microdata Series (IPUMS) database served as the data source. The respondents were 5402 women from Uganda and Malawi. The response variable was whether the woman had been physically harmed by her current husband or partner during pregnancy (DVPREGHUSB). We examined six predictor variables. Stepwise logistic regression analysis revealed that four variables were important predictors of DVPREGHUSB: country, marital status, woman's education, and husband's education. Women in Uganda were more likely to be physically abused than women in Malawi. Those who were living together (unmarried), widowed, divorced, or separated were less likely to be physically abused than those who were married. A woman's level of education was not a significant predictor of the physical abuse of women in both Uganda and Malawi. Men with primary education were more likely to physically abuse their wives or partners than those without education. Programs aimed at helping physically abused women must consider the country of residence, marital status, and education of the husband or partner. [ABSTRACT FROM AUTHOR]